d. Nursing personnel should always auscultate the patient's lungs before and
after percussion or coughing and deep breathing exercises. In this way, an observation
regarding the effectiveness of the treatment can be made.
Section III. DIAGNOSTIC STUDIES
2-11. LABORATORY STUDIES
a. Sputum is collected and studied for the presence of white blood cells,
bacteria, and abnormal cells. Cultures of sputum may be done to determine sensitivity
or resistance to drugs when the physician must choose an antibiotic therapy.
b. Pleural fluid will accumulate in the parietal cavity in abnormal amounts in
certain disease conditions. The fluid is studied to determine the cause of the abnormal
accumulation. Pleural fluid is normally obtained by aspiration. This procedure is called
thoracentesis and will be discussed in another section.
c. Arterial blood gas (ABG) studies provide a means of assessing the adequacy
of ventilation and oxygenation, and help assess the acid-base state of the body.
2-12. OTHER STUDIES
a. X-rays of the chest show the position of normal structures within the thorax.
Displacement of structures, abnormal shadows, or abnormal densities are indicative of
some abnormal pathology.
b. Pulmonary function tests (PFTs) are ventilatory function tests done to detect
and measure abnormalities in respiratory function. These tests involve measurement of
the amount of air the patient is able to inhale and exhale.
c. Bronchoscopy is the direct visualization of the larynx, trachea, and bronchi
through an instrument called a bronchoscope. Bronchoscopes may be flexible or rigid.
The bronchoscope is used not only to examine, but also to diagnose bleeding sites, to
excise lesions, to remove obstructions or secretions, and to collect specimens for
biopsy, cytologic, or bacteriologic study.
Section IV. SPECIAL NURSING MANAGEMENT
2-13. COUGHS AND DEEP BREATHE
a. Unless contraindicated, coughing is encouraged in order to clear mucous
secretions from the trachea and bronchi. If secretions are allowed to accumulate, they
block the air passages and prevent air from reaching lung tissue. Effective coughing,
deep breathing, and change of position are all measures that help to promote complete
aeration of lung tissue in bedridden, debilitated, and postoperative patients. When